Description and results of a new method for assessing real-life performance of a UV-C disinfection robot.

Background: Due to the disadvantages of manual disinfection of patient rooms, mobile disinfection robots using ultraviolet C (UV-C) radiation are increasingly being used. Assessing their in situ effectiveness remains challenging.

Aim: This study describes a new method to prove adequate in situ disinfection (≥5-log reduction in bacterial load), and uses this method to assess the efficacy of a mobile disinfection robot using UV-C radiation.

Increase in gut permeability and oxidized ldl is associated with post-acute sequelae of SARS-CoV-2.

Background: Post-acute sequelae of SARS-CoV-2 (PASC) is marked by persistent or newly developing symptoms beyond 4 weeks of infection. Investigating gut integrity, oxidized lipids and inflammatory markers is important for understanding PASC pathogenesis.

Methods: A cross-sectional study including COVID+ with PASC, COVID+ without PASC, and COVID-negative (COVID-) participants.

Estimating the effect of vehicle speeds on bicycle and pedestrian safety on the Georgia arterial roadway network.

Cyclists and pedestrians account for a disproportionate amount of the world's 1.3 million road deaths every year. This is a growing problem in the United Sates where bicyclist and pedestrian fatalities have increased steadily since 2009.

A framework for localizing global climate solutions and their carbon reduction potential.

Localized carbon reduction strategies are especially critical in states and regions that lack top-down climate leadership. This paper illustrates the use of coupled systems in assessments of subnational climate solutions with a case study of Georgia, a state located in the southeastern United States that does not have statewide climate goals or plans. The paper illustrates how robust place-specific plans for climate action could be derived from foundational global and national work and by embedding that research into the context of socio-ecological-technological systems.

Hidden work in hepatopancreaticobiliary surgery: the contemporary demands of non-operative patient management.

Background: Increasing use is now made of modalities other than surgery (including endoscopy and interventional radiology) in the care of patients with hepatopancreaticobiliary (HPB) diseases. However, the care of and responsibility for patients managed non-operatively continues to reside with surgical services. This investigation was undertaken to quantify the implications of non-operative patient related admissions our HPB unit over a 24 month period.

Prehospital Ketamine Use for Rapid Sequence Intubation: Are Higher Doses Associated With Adverse Events?

Objective: Ketamine for rapid sequence intubation (RSI) is typically dosed at 1 to 2 mg/kg intravenously. The need to ensure dissociation during RSI led some to administer ketamine at doses greater than 2 mg/kg. This study assessed associations between ketamine dose and adverse events.

Translating a Global Emission-Reduction Framework for Subnational Climate Action: A Case Study from the State of Georgia.

Subnational entities are recognizing the need to systematically examine options for reducing their carbon footprints. However, few robust and comprehensive analyses are available that lay out how US states and regions can most effectively contribute. This paper describes an approach developed for Georgia-a state in the southeastern United States called "Drawdown Georgia", our research involves (1) understanding Georgia's baseline carbon footprint and trends, (2) identifying the universe of Georgia-specific carbon-reduction solutions that could be impactful by 2030, (3) estimating the greenhouse gas reduction potential of these high-impact 2030 solutions for Georgia, and (4) estimating associated costs and benefits while also considering how the solutions might impact societal priorities, such as economic development opportunities, public health, environmental benefits, and equity.

Treatment of gastric adenocarcinoma at a New Zealand centre: meeting the challenges of a low volume country.

Background: Surgical treatment of gastric cancer in New Zealand is challenging because of a low annual incidence of 400 patients and population dispersal over a wide area with little data on regional treatment trends and outcomes. This investigation was undertaken to evaluate the surgical outcomes of gastric cancer patients presenting to a single upper gastrointestinal centre (WDHB, Waitemata District Health Board) and to compare these to national and international standards.

Methods: Data on 135 patients with histologically proven gastric adenocarcinoma presenting between January 2010 and December 2014 were reviewed and compared with nationally available procedural volume data.

MOVES-Matrix for high-performance on-road energy and running emission rate modeling applications.

The MOVES model was developed by the U.S. Environmental Protection Agency (U.

Oesophagectomy at a New Zealand regional centre: where to now?

Background: This study aims to define contemporary trends in characteristics, costs and management of patients diagnosed with oesophageal adenocarcinoma in New Zealand.

Methods: Clinical, pathological and management data of the 135 patients presenting with histologically proven adenocarcinoma to our institution over a 5-year period (January 2010 to December 2014) was collected. Primary analysis reviewed patient demographics, co-morbidities, treatment strategy and survival.

Role of post-operative serum C-reactive protein levels as a predictor of complications in upper gastrointestinal surgery.

Background: This study was undertaken to assess the value of C-reactive protein (CRP) in predicting infective complications after elective upper gastrointestinal surgery.

Methods: Demographic data, clinical outcomes and serial CRPs preoperatively to post-operative day (POD) 7 were collected for patients undergoing pancreatectomy, hepatectomy and oesophago-gastrectomy between 2005 and 2016. Areas under the curve (AUC) were used to evaluate diagnostic accuracy per day of measurement.

Can post encroachment time substitute intersection characteristics in crash prediction models?

Introduction: Transportation safety analyses have traditionally relied on crash data. The limitations of these crash data in terms of timeliness and efficiency are well understood and many studies have explored the feasibility of using alternative surrogate measures for evaluation of road safety. Surrogate safety measures have the potential to estimate crash frequency, while requiring reduced data collection efforts relative to crash data based measures.

The volume, cost and outcomes of pancreatic resection in a regional centre in New Zealand.

Background: The frequency, costs and outcome of pancreatic resection (both pancreaticoduodenectomy and distal pancreatectomy) were reviewed in our own institution and correlated with regional population growth as well as national resection rates and locations.

Methods: Demographic, pathological and outcome data on pancreaticoduodenectomy and distal pancreatectomy were obtained from a prospectively maintained database for the years 2005-2009 and 2010-2014. During this period, the catchment population grew from 460 000 to 567 000.

Endoscopic assessment and management of sporadic duodenal adenomas: The results of single centre multidisciplinary management.

Aim: To review the role of multidisciplinary management in treating sporadic duodenal adenomas (SDA).

Methods: SDA managed at North Shore Hospital between 2009-2014 were entered into a prospective database. Pathology, endoscopic and surgical management as well as follow up were reviewed.

Safety impacts of bicycle infrastructure: A critical review.

Problem And Method: This paper takes a critical look at the present state of bicycle infrastructure treatment safety research, highlighting data needs. Safety literature relating to 22 bicycle treatments is examined, including findings, study methodologies, and data sources used in the studies. Some preliminary conclusions related to research efficacy are drawn from the available data and findings in the research.

Understanding the emission impacts of high-occupancy vehicle (HOV) to high-occupancy toll (HOT) lane conversions: Experience from Atlanta, Georgia.

Unlabelled: Converting a congested high-occupancy vehicle (HOV) lane into a high-occupancy toll (HOT) lane is a viable option for improving travel time reliability for carpools and buses that use the managed lane. However, the emission impacts of HOV-to-HOT conversions are not well understood. The lack of emission impact quantification for HOT conversions creates a policy challenge for agencies making transportation funding choices.

Milwaukee Health System Leverages Telemedicine During Triage Process at Multiple ED Sites.

Working with an entrepreneurial startup company, Aurora Health Care in Milwaukee has developed an approach for leveraging the services of one provider who sees patients remotely during the triage process at multiple ED sites. The process has enabled the health system to accelerate throughput times while maximizing provider resources and boosting patient satisfaction. At Aurora Sinai Medical Center in Milwaukee, the approach has reduced door-to-provider times from 60 minutes to about 10 minutes, on average.

MOVES-Matrix and distributed computing for microscale line source dispersion analysis.

Unlabelled: MOVES and AERMOD are the U.S. Environmental Protection Agency's recommended models for use in project-level transportation conformity and hot-spot analysis.

From scratch: developing a hepatic resection service for metastatic colorectal cancer.

Background: Waitemata District Health Board has New Zealand's largest catchment and busiest colorectal unit. The upper gastrointestinal unit was established in 2005, in part to provide a hepatic resection service for patients with colorectal carcinoma metastatic to the liver. The aim of this investigation was to report on quality indicators for the hepatic resection of colorectal carcinoma in the development of a regional resection service.

Development and initial outcomes of an upper gastrointestinal multidisciplinary clinic.

Introduction: Patients with upper gastrointestinal cancer are often comorbid and require complex surgical treatments for their cancers, meaning that their preoperative assessment can be based around numerous outpatient assessments with multiple services. A multidisciplinary clinic (MDC) was developed for the assessment of patients with confirmed or suspected upper gastrointestinal cancers.

Methods: Face-to-face meetings were held between stakeholder services at Waitemata District Health Board, and clinic resource allocated.

Quadrate lobe: a reliable landmark for bile duct anatomy during laparoscopic cholecystectomy.

Background: This investigation was undertaken to determine whether the shape of the inferior surface quadrate lobe (segment IV) can assist in defining a safe starting point for dissection during laparoscopic cholecystectomy.

Methods: Patients undergoing laparoscopic cholecystectomy were prospectively audited. Intraoperative cholangiograms and photographs of the quadrate lobe were reviewed measuring the angle between the cystic duct and common bile duct and its relationship to quadrate shape.

Voriconazole Therapeutic Drug Monitoring Practices in Intensive Care.

Background: Routine therapeutic drug monitoring of voriconazole seems to be beneficial. This study investigated the therapeutic drug monitoring practices in intensive care to derive possible recommendations for improvement.

Methods: A retrospective chart review was performed for patients aged ≥18 years who started treatment with voriconazole, which lasted for at least 3 days while being admitted to an intensive care unit to assess possible differences between the patients with and without voriconazole trough concentrations measured.